Laserfiche WebLink
SITE MITIGATION PROGRAM <br /> BILLING LETTER OF ACKNOWLEDGEMENT: <br /> TO: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION (PHS-EHD) <br /> 445 N. SAN JOAQUIN ST. <br /> P. 0. BOX 2009 <br /> STOCKTON, CA 95201 <br /> FROM: KEARaEy - KPF <br /> (property owner name) <br /> ((02t4 EAST gLPInIE AvE. <br /> (owner mailing address) <br /> SToct-LTON / C Iq 95205 <br /> (city, state, ZIP) <br /> SgME AS Above <br /> RE: <br /> (site address) <br /> I (We) declare that the assessment activity being performed at the <br /> above referenced site is being conducted with my(our) knowledge and <br /> approval. Furthermore, I(we) acknowledge that payment of PHS-EHD <br /> charges will become my(our) responsibility in the event said <br /> charges are not paid by the client and/or operator identified on <br /> the attached "Site Mitigation Acknowledgement/Request for Services <br /> Form. " <br /> LNNT IV6,p, ao�- 838 <br /> (sign and title) (phone number) <br /> LC\BILACKN. FRM <br />